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Evaluation of Right Ventricular Function in Experimental Models of Pulmonary Arterial Hypertension
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Evaluation of Right Ventricular Function in Experimental Models of Pulmonary Arterial Hypertension

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Elevated pulmonary artery systolic pressure in patients with coronary artery disease and left ventricular

Guo-Hui Yan1, Mei Wang, Wen-Sheng Yue

  • 1Cardiology Division, Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Rm 1928, Block K, Queen Mary Hospital, Hong Kong, Hong Kong.

European Journal of Heart Failure
|August 3, 2010
PubMed

Insights

Elevated pulmonary artery systolic pressure (PASP) in coronary artery disease (CAD) patients is linked to both inter- and intra-ventricular systolic dyssynchrony. These findings highlight the role of mechanical dyssynchrony in CAD-related PASP.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiovascular Physiology

Background:

  • Coronary artery disease (CAD) can lead to elevated pulmonary artery systolic pressure (PASP), even with preserved left ventricular ejection fraction (LVEF).
  • The contribution of ventricular dyssynchrony to PASP in CAD patients is not fully understood.

Purpose of the Study:

  • To investigate the association between inter- and intra-ventricular systolic dyssynchrony and elevated PASP in patients with CAD.
  • To identify predictors of elevated PASP in this population.

Main Methods:

  • Echocardiography was used to assess PASP, inter-ventricular dyssynchrony (Ts-RL), and intra-ventricular dyssynchrony (Ts-SD, Ts-12, Ts-6-basal) in 153 CAD patients with LVEF >40%.
  • Multivariate analysis identified independent predictors of elevated PASP.

Main Results:

  • Patients with elevated PASP (>35 mmHg) exhibited significantly prolonged intra-ventricular (Ts-SD, Ts-12, Ts-6-basal) and inter-ventricular (Ts-RL) dyssynchrony compared to those without.
  • Indexes of dyssynchrony and left ventricular (LV) filling pressure (E/e') correlated significantly with PASP.
  • Independent predictors of elevated PASP included left atrial dimension, E/e' septal, pulmonary vascular resistance, and Ts-RL.

Conclusions:

  • Elevated PASP is prevalent in CAD patients with preserved LVEF.
  • LV diastolic dysfunction and LV mechanical dyssynchrony are associated with elevated PASP in CAD.
Abstract

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